Polyneuropathy is a disease of the peripheral nerves. Typically, patients suffering from polyneuropathy experience chronic pain. In many cases polyneuropathy is a symptom of diabetes mellitus.
The tibial nerve is a branch of the sciatic nerve that passes alongside the tibia and into the foot. At the ankle, the tibial nerve is relatively close to the surface of the skin. In percutaneous tibial nerve stimulation, a percutaneous electrode is inserted into the subject's ankle, and the tibial nerve is stimulated, for example, in order to treat pelvic pain and/or incontinence.
U.S. Pat. No. 6,735,474 to Loeb describes a method and system for treatment of incontinence and/or pelvic pain including the injection or laparoscopic implantation of one or more battery- or radiofrequency-powered microstimulators beneath the skin of the perineum and/or adjacent the tibial nerve. The devices are described as being programmed using radio-frequency control via an external controller that can be used by a physician to produce patterns of output stimulation pulses judged to be efficacious by appropriate clinical testing to diminish symptoms. The stimulation program is described as being retained in the microstimulator device or external controller and as being transmitted when commanded to start and stop by a signal from the patient or caregiver. The system and method are described as reducing the incidence of unintentional episodes of bladder emptying by stimulating nerve pathways that diminish involuntary bladder contractions, improving closure of the bladder outlet, and/or improving the long-term health of the urinary system by increasing bladder capacity and period between emptying. The incidence of fecal incontinence is described as being similarly reduced or eliminated. Furthermore, the system and method are described as reducing or eliminating the incidence of pelvic pain by chronically stimulating nerve pathways that derive from the sacral roots using a miniature implantable neurostimulator that can be implanted with a minimal surgical procedure. The system and method are described as allowing a patient to be taught to receive one or more patterns of neural stimulation that can be prescribed by a physician and administered without continuous oversight by a clinical practitioner.
Neuros Medical (Ohio, USA) manufactures a system that is described as delivering high-frequency stimulation to sensory nerves in the peripheral nervous system to block chronic pain. The system consists of an electrode (also known as a lead) placed around a peripheral nerve and powered by a pace-maker size generator that is implanted into the chest cavity, abdomen, or lower leg. In a press release, dated Mar. 17, 2009 it was stated that the generator operates in a much higher frequency range than conventional neurostimulation devices, and, therefore, the technology is able to stop nerve activity to block pain completely, as opposed to simply masking the pain signal.
Uroplasty Inc. (Minnesota, USA) manufactures the Urgent® PC Neuromodulation System, which is described as using percutaneous tibial nerve stimulation (PINS) for treating urinary urgency, urinary frequency, and urge incontinence.
The following references may be of interest:
U.S. Pat. No. 7,536,226 to Williams
U.S. Pat. No. 6,829,508 to Schulman
U.S. Pat. No. 6,272,383 to Grey
US 2008/0039915 to Van Den Biggelaar
US 2006/0271137 to Stanton-Hicks
US 2006/0155345 to Williams
US 2005/0143789 to Whitehurst
US 2004/0254624 to Johnson
“Is electrical stimulation effective in reducing neuropathic pain in patients with diabetes?” by Armstrong, J Foot Ankle Surg. 1997 July-August; 36(4):260-3
“Responses to Median and Tibial Nerve Stimulation in Patients with Chronic Neuropathic Pain,” by Theuvenet, Brain Topography, Volume 11, Number 4, 1999, pp. 305-313(9)